MEMORY AND MEMORY IMPROVEMENT Dennis Kelly, Ph.D., Neuropsychologist Traumatic Brain Injury Program Madigan Health Care System

1
MEMORY AND MEMORY IMPROVEMENTDennis Kelly,
Ph.D., NeuropsychologistTraumatic Brain Injury
ProgramMadigan Health Care System

• Washington TBI Conference
• 28 April 2011

2
Sample Topics to be Covered

• How does information get into memory?
• Why do I forget things?
• What are some general approaches to memory
  rehabilitation?
• What specifically can I do to improve my memory?

3
MEMORY STAGES

• Encoding (Input)
• Storage (Short-Term and Long-Term)
• Retrieval (Output)
• Memory failures can occur at any of these stages.

4
TYPICAL MEMORY FLOW
Repetition Improves Retention
Long-Term Memory System
Episodic (Autobiographical) Semantic ( Facts
Knowledge) Procedural (Motor Skill-Based)
Short-Term Memory System
Sensory Input
Consolidation
Permanent Loss due to Interference, Disuse, or
Neural Shock
Temporary or Permanent Loss due to Significant
Illness or Injury
5
Short-Term vs. Long-Term Memory

• STM

• LTM

• Mostly auditory encoding
• Retained for a matter of minutes
• Highly susceptible to interference
• Limited storage capacity

• Semantic encoding
• Can be retained for years
• Less susceptible to interference
• Large storage capacity

6
Example of a Semantic Network in Long-Term Memory
Living Thing
IS
IS
Animal
Plant
IS
IS
IS
IS NOT
IS NOT
Bird
Mammal
Tree
CAN LIVE IN
HAS
Wings
IS
IS
IS
IS
IS
HAS
HAS
Penguin
Robin
Dog
Lion
Bat
FLIES
HAS
Red Breast
WALK ON 4 LEGS
CANNOT
7
MEMORY IS A GENERAL TERM WITH SURPLUS MEANING.
8
People often report problems with memory that
actually are due to other things, such as

• Sensory limitations
• Sleep disturbance
• Not paying attention
• Physical pain
• Emotional distress
• Drug and/or medication effects

9
IF THE PREVIOUS OBSTACLES ARE REDUCED, YOUR
MEMORY WILL IMPROVE.
10
Memory is Not Perfect Things We Normally Forget

• Percent of people who experience each of the
  following even though they didnt have a head
  injury
• Forget telephone numbers 58
• Forget peoples names 48
• Forget where car was parked 32
• Lose car keys 31
• Forget groceries 28
• Forget why they entered a room 27
• Forget directions 24
• Forget appointment dates 20
• Lose wallet or pocketbook 17
• Forget content of daily conversations 17

11
Has This Happened to You?
12
General Rehabilitation Approaches

• Restoration of damaged functions
• Optimization of residual functions
• Compensation for lost functions

13
Restoration of Damaged Functions

• Targets underlying impairment
• Attempts to restore/heal damaged memory
• Typical techniques
• Repetition
• Practice (distributed better than massed)
• Overlearning

14
Optimization of Residual Functions

• Targets underlying impairment
• Attempts to retrain normal memory
• Typical techniques
• Chunking
• First letter cueing
• Imagery and association
• Mental organization

15
Compensation for Lost Functions

• Targets functional deficits
• Attempts to bypass memory deficits
• Typical techniques
• Labels/ lists
• Notebooks/diaries/calendars
• Alarms/timers
• Electronic organizers

16
STIMULATION VS. OVERSTIMULATION

• The first is good, but the second can be bad.

17
IF ONLY IT WAS THIS EASY
18
MEMORY IMPROVEMENT

• Its not necessary to remember everything
• There are advantages to forgetting
• Prioritize Focus on what you need to remember
  and for what purpose. Decide which things
• Need your immediate attention
• Can be put on the back burner for later
• Can simply be deleted (like junk mail)

19
GENERAL MEMORY IMPROVEMENT STRATEGIES

• Reduce the obstacles mentioned previously
• Use Repetition
• Use Repetition
• Be physically organized (e.g., use bookmarks,
  filing systems keep important things in a
  predictable place)
• Use External memory aids (e.g., cell phones,
  lists, sticky notes, alarms, Day Timer, pill
  organizers, other people)

20
(No Transcript)
21
More is Not Always Better
22
GENERAL MEMORY IMPROVEMENT STRATEGIES

• Internal memory aids make things personally
  meaningful, and link them with what you already
  know active approach to improving memory. Some
  examples
• Chunking
• First Letter Cueing
• Imagery
• Mental Organization

23
CHUNKING

• Short-term memory typically can retain between 5
  9 chunks
• Chunk a meaningful unit of information can
  be small or relatively large
• Group material into segments that are easier to
  remember

24
CHUNKING

• The boy in the red shirt kicked his mother in
  the shin.
• Contains 12 words 43 letters
• Easier to remember if we reduce it to 3 chunks
• The boy in the red shirt
• kicked his mother
• in the shin.
• 2 5 3 9 6 8 0 6 0 6
• Contains 10 digits
• Easier to remember if we reduce it to 3 chunks
• (253) 968- 0606

25
FIRST LETTER CUEING

• Good for remembering sequences
• ROY G BIV ROY G BIV colors of the
  spectrum
• Fire Extinguisher ? P A S S
• Pull pin Aim hose Squeeze handle Sweep from
  side to side
• Grocery Items
• Chicken Basil Shrimp CBS

26
IMAGERY

• Make mental pictures e.g., to link pairs of
  words together, such as apple and lightbulb,
  
• or dollar and snake
• Can involve senses other than visual e.g.,
  songs
• Method of Loci -- visual imagery method using
  place with which you are familiar to attach
  things to remember e.g., remembering shopping
  list by walking through your house

27
Can You Remember These Names?

• Ruby Farmer
• Liz Woodson
• Nick Rollins
• Russ Browning

28
MENTAL ORGANIZATION

• Planning
• Outlining
• Using categories and subcategories

29
Try to remember the following list by organizing
it into categories

• Motorcycle
• Dump truck
• SUV
• Bus
• Rickshaw
• Jet plane
• Compact car
• Bicycle

30
S Q 3R

• Method for learning and remembering new material

Especially useful for academic
coursework
Survey, Question, Read, Recite,
Review
31
Take-Home Points

• Memory is not perfect but it can be improved
• Dont waste time on things that dont need to be
  remembered
• Work your brain (but not too much)
• If obstacles to memory are reduced, your memory
  will improve

32
Take-Home Points (Cont.)

• Try to get information from short-term memory
  into long-term memory
• Try to link new learning to old learning
• Use all 3 rehabilitation approaches
• Restoration (e.g., repetition practice)
• Optimization (e.g., chunking imagery)
• Compensation (e.g., lists electronics)

33
QUESTIONS?